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Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> Type of Notification [ ] Original [ J Amended [ J Project Cancellation <br /> Demolition Contractor,* Building Informatinn� <br /> p r <br /> Name: /'/` AT Building Name:_ ��S i !�n?0 L G .q,eof e <br /> Address:" 3l /,& If F 5 /• Address/Location: A) <br /> S k City,State,Zip: ��D�0-".to <br /> City,State,Zip: �S3�� County- /r/e-it rt�,Oi •1 <br /> Contact Person: Tc el'( ! 'C'/ / <br /> Phone Number(s): 9' <br /> Phone Number(s): 'z S' a Age of Bldg.(years):_ , j Size of Bldg.(sq.ft.): <br /> —LO—C <br /> Building Owner: <br /> Number of Floors Including Basement Level(s): <br /> 2�r <br /> I G / Present Use of Bldg.: e <br /> Name:— /3/-kA e f /� ��Y � �/ Prior Use of Bldg.: 61 4/1 e G e <br /> Address: 3D <br /> Dates when demolition or intentional burning <br /> will Begin ' �C> 0-24 End /�- � C) <br /> City,State,Zip: <br /> Notification must be postmarked or received ten(10)working days <br /> Contact person:_ l D n Tri'/` / before demolition begins. *See item#S for emergency demolitions. <br /> Phone Number(s): _ X15 �7 92 ^d Both Beginning and Ending dates should be amended in writing as <br /> necessary to reflect current project dates. <br /> If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material(RACM) in the building <br /> to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of MN- <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. <br /> Is nonfriable ACM present in the structure to be demolished ? [ J YES ((NO <br /> If YES complete items 1-9. If NO complete items 3-9. <br /> 1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II <br /> nonfriable ACM left in place. <br /> Categ.I Linear Feet Categ.II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> Category I nonfriable ACM means asbestos-containing packings, Category II nonfriable ACM-means any material,excluding <br /> gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable ACM,containing more than one percent <br /> containing more than one percent asbestos. asbestos that,when dry,cannot be crumbled,pulverized,or <br /> *Category I nonfriable ACM is not allowed to remain in place reduced to a powder by hand pressure. <br /> for demolition if it is in poor condition. *Category II nonfriable ACM is not allowed to remain in place <br /> for demolition if it has a high probability of becoming crumbled, <br /> pulverized,or reduced to a powder during demolition,transport, <br /> or disposal. (ex transite,cement,slate roofing) <br /> 2. Description & Location of ACM remaining in place(including floor#and room <br />